30例经皮球囊肺动脉瓣成形术

PERCUTANEOUS TRANSLUMINAL BALLOON PULMONARY VALVULOPLASTY, FURTHER EXPERIENCE OF 30 CASES

报告30例经皮球囊肺动脉瓣成形术(PBPV)治疗先天性肺动脉瓣狭窄的经验。患者年龄3～32岁,平均11.1岁。29例为单纯肺动脉瓣狭窄,1例同时合并小的房间隔缺损。PBPV前主肺动脉—右室收缩压差40～150mmHg,平均87mmHg,(法定计量单位为kPa,1kPa=0.133322mmHg);术后降至4.8～5mmHg。10例子术后22～34个月复查右心导管,主肺动脉—右心室平均收缩压差自20mmHg进一步降至14mmHg。10例中6例心电图示原有右心室肥厚消失。本文讨论了PBPV的适应证、操作以及继发性流出道狭窄和疗效的关系。本组病例经验表明,合并重度继发性动力性流出道狭窄和小房间隔缺损并非PBPV的禁忌证。

The result of percutaneous balloon valvuloplasty procedure in 30 pati ents aged 3-32 years(mean 11.1), with congenital pulmonary valve stenosis is reported. Among them, 29 casas were isolated stenosis of pulmonary valve and the remaining one was associated with a small atrial septal defect. Before PBPV, main pulmonary artery/right. ventricle peak systolic pressure gradient was 40-150mmHg (mean 87.4), and after the procedure the systolic pressure gradient was reduced to 5-45mmHg (mean 21.8). In 10 cases, follow-up cardiac catheterizations at intervals of 22-34 months were performed, and the peak systolic pressure gradient was reduced from 20 to 14mmHg, and in 6 out of 10 cases right vetricular hypertrophy shown on ECG disappeared. The indications and techniques of PBPV as well as secondary infundibular stenosis and the results of PBPV were pertinently discussed. The experience of PBPV in 30 cases of the present series indicates that associated secondary dynamic infundibular stenosis of right ventricle as well as small atrial septal defect does not constitute contraindications of PBPV.